Happy Anniversary, You Look Great!

September 24, 2018

I can’t tell you now many times I’ve heard how great I look in the past 6 months. Even my oncologists keep telling me how good I look despite all that they’ve done to me. Believe me… I feel every ounce of what’s been done to me since starting this journey.

The last 12 months have been full of appointments, tests, discussions, treatments,  therapies and a lot of trepidation with each.

It started a year ago when I found what would turn out to be a 5.2 cm (~2 inch) cancerous tumor in my right breast. Invasive Ductile Carcinoma. This kind is the most common type of breast cancer. The bio markers I have, though, are more rare.

Below is a short list of all I’ve been through with this disease in the last year since finding my tumor.

First, I got the 3D mammogram with ultrasound in Denver when and where I learned how big (and bad) it really was and was told I needed to get home so I could get started on getting it treated.

When I returned home to Seattle, I had a series of staging scans to see the extent of the damage beyond my breast and lymph nodes.

  • 1 breast MRI with contrast
  • 1 CT scan of my chest to double check a possible node in my lung
  • 1 PET scan with contrast
  • 1 bone scan
  • 1 minor surgery to install a chemo port in my chest

Treatment started a month later.

  • 4 rounds in 8 weeks of two of the harshest chemo drugs in use.
  • 16 weekly doses of Taxol.
  • 11 doses of Herceptin and Perjeta given every 3 weeks. The plan is to have these drugs for a year. I started them in February along with the Taxol.

Pre-Surgery Diagnostics 

  • 1 mammogram with ultrasound in part to measure how well the chemo shrunk my tumors.
  • 1 MRI with contrast so my surgeon can ensure she knows where the cancer is when she does the surgery to remove it.
  • 1 chest CT scan to verify that the node in my lung is or is not active – thankfully it resolved.

Surgery

  • 1 lumpectomy and bilateral breast lift – major surgery with 6 week recovery*

Pre-Radiation Diagnostics 

  • 1 MRI with contrast to get measurements for radiation treatments and ensure there was no new growth.
  • 1 CT scans – measure any new growth in the existing tumor beds and get measurements for radiation treatments.
  • 1 PET scans with contrast make sure there were no new growths anywhere. Unfortunately, I had a new lymph node become active between the surgery recovery and start of radiation.

Endoscopy – biopsy of new lymph mediastinal lymph node – it was positive for metastatic breast cancer. I am now Stage IV. This sucks.

Radiation

  • 7-1/2 weeks of daily radiation treatments to my breast, mid-chest and armpits.
  • 6 weekly doses of Cisplatin, a radiosensitizer to help kill the cancer in each of the areas being treated with radiation.

Recovery from all of the treatments from chemo to radiation will likely take months to years despite the chemicals leaving my system within a couple of months of receiving the last doses.

Chemo by the numbers

4 IV doses doxyrubicin (Adriamycin) given with equivalent doses of cyclophosphamide – 6-8 hour infusion time
16 IV doses of Taxol – 5 hour infusion time
6 IV doses of Cisplatin – 6 hour infusion time
11 IV doses of Herceptin and Perjeta – 3 hour infusion time
4 IV doses of Kadcyla – 1 hour infusion time

This is what a year with cancer looks like. A cancer that, by all accounts, doesn’t want to be tamed into remission. A cancer that wants me dead when I’ve got years of things left that I want to do.

I haven’t even begun to tally up all the hours cancer has stolen in the past year – hours spent driving to and from appointments and treatments – hours away from work – hours of vacation time spent on appointments and treatments instead of things I enjoy – hours away from friends and family – all of the family events, happy hours, festivals, and concerts I couldn’t attend because it was too much of a risk to be out with people due to low blood counts – all of the places and things I’ve wanted to show my family about the beautiful place I live – all of the times I’ve had to stay home and not go out and do things I enjoy because I was too tired to make the drive.

So much time and so many experiences that I will never get back all for a disease I never  dreamed I’d ever actually get. I always thought I’d die from something else. Life throws you a curveball sometimes. I’m glad I happened to catch this one before it completely smacked me in the face.

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What to Eat – Quinoa Fried Rice

One of my good friends made this for me when she picked me up from the surgery to install my port. It’s pretty easy to make, and it’s light and delicious. I like it better, honestly than actual fried rice.

This recipe is from Fashionable Foods

Quinoa Fried Rice

Ingredients

2 Tablespoons Coconut Oil, divided (or vegetable oil)
2 Eggs, seasoned with salt and pepper and beaten
1 Small Onion or bunch of scallions, chopped
2 Carrots, grated
2 Heads Baby Bok Choy, thinly sliced, keep stems and leaves separated
2 Garlic Cloves, finely chopped
1-inch Piece of Fresh Ginger, grated
1 Cup Finely Chopped Kale
Kosher Salt & Freshly Ground Black Pepper
3 Cups Previously Cooked Quinoa*
½ Cup Frozen Peas
Soy Sauce (Wheat-Free or Tamari), or regular if not gluten-free** (see note)
Optional: Rotisserie chicken breast, chopped

Instructions

Heat 1 teaspoon of the coconut oil in a wok over high heat. Once it’s melted, pour in the beaten eggs and cook until the eggs are set, moving them gently. (You’re just making scrambled eggs here). Remove the eggs from the wok into a large bowl and set aside.

Add 2 teaspoons of the coconut oil into the hot wok and once it’s melted add in the onion, carrots, and bok choy stems. Stir fry for 1-2 minutes or until the veggies gain some color and soften. Add in the garlic and grated ginger and stir-fry for 30 seconds.

Add in the bok choy leaves and kale and stir-fry until they wilt down. Season the mix with salt and pepper. Remove the veggies to the large bowl with the eggs and set aside.
Heat the remaining tablespoon of coconut oil over high heat. Once it’s melted add in the cooked quinoa. Stir-fry the quinoa for 2-3 minutes.

Add in the frozen peas and corn and mix well. Then, toss in the vegetables and egg. Mix until well combined and then turn off the heat.

Stir in soy sauce – I just eyeball this. If you made me guess I’d say around 2 tablespoons. Then, when I serve it I top it with more soy sauce.
Notes
*Leftover quinoa works best for this recipe. To make quinoa: measure out 1 cup of quinoa and add it to a fine mesh strainer. Rinse it very well. Heat a medium pot over high heat and add a little oil. Add in the quinoa and allow it to “toast” until the water evaporates. Add in 1 3/4 of water, cover and bring to a boil. Once boiling, lower the heat to low and allow the quinoa to simmer for 15 minutes. Let rest for 10 minutes before fluffing with a fork. Chill the quinoa before using in this recipe.

If you don’t have bok choy you can use all kale or even add in spinach. Any combination of greens will work!

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Bra Shopping Part I

August 21, 2018

In a way, I’ve been looking forward to going bra shopping since I had my surgery. I had asked my surgeon to do a significant reduction in my breast size, so none of my old bras were supposed to fit anymore. It was a rude awakening to find out that I wasn’t the size I wanted to be when I woke up from surgery.

After surgery, I came home with a couple of Masthead surgical bras with Velcro straps and front closures. They were pretty comfortable. After a while the Velcro straps getting caught on all of my shirts was getting pretty annoying, so I also ordered what they called a recovery bra. I hated this bra. It has 7 hooks in the front. What the hell were they thinking? They were hard to close and keep closed when I was still putting gauze on my incisions.

I went to the mall in search of sports bras the day I had my drain removed during my post-op follow-up. I made the mistake of starting at Victoria’s Secret. Mistake because (a) I wasn’t supposed to be wearing a bra with an underwire, and (b) their idea of measuring is different from everyone else, and (c) I was still pretty swollen, so whatever size they thought I’d be was supposed to change anyway. As I wrote before, when they told me I was still a “D” cup, I almost cried in the store. I bought a few of their sports bras and ended up looking for something else soon after because the sports bras from VS were just too tight, which made them too hot, which made them uncomfortable. I ended up scrapping them pretty quickly and going back to the Masthead bras til I could find something comfortable and supportive.

There were a couple of bras that I had before that fit decently enough and I pulled them back out of the donation pile. I wore them sparingly in the past couple of months because they’re underwire bras. The area on the sides of my breasts under my arms is still sensitive to pressure, and with radiation, that skin is also more tender and susceptible to injury, so I needed something that won’t pinch.

Eventually, I found some simple sports bras from Jockey that fit, didn’t hurt and zipped up the front because I couldn’t (and wasn’t supposed to) pull my arms behind my back for about 6 weeks after surgery. I’d made up my mind when I bought them that they would be temporary, and that when I finished radiation, I’d go get some new “real” bras.

This week I happened into Kohl’s to look at towels. As I was heading toward the front of the store, I was passing the bra section and thought I’d take a look around. There are a lot of new styles that don’t include underwires. Woohoo! Realizing that I am just past 3 months post-op, I decided to take a look around.

Warner’s was one of my favorite brands before my surgery. I bought a couple of new ones right around a year ago. They always felt good, had nice styles and fit decently for how I was built. They are also one of the few brands that have come out with a line of bras without underwires. I found a couple of styles and went to the dressing room to try them on. Apparently bras and how they fit has changes significantly in the last year. Once in the dressing room, I found I could barely clip the first set of hooks, and not one of them fit in the cups at all. I was more disappointed than anything because this now means that bra shopping is going to take a lot of time and work to find something that fits and feels good. It also means I’m going to have to go somewhere like Nordstrom’s that has a dedicated fitting person who can help me figure out what size and style are going to work best for me. Why not just get Jockey bras? Because they have a completely different and custom system from everyone else. The last thing I want is to have to buy special bras from a special place every time I need to replace one.

I’ve still got a month from the end of radiation to wear the Jockey sports bras because I’ll need to continue putting the burn cream on where I got radiation. So there’s plenty of time to go look for bras. By then I should have some of my energy back, too.

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What to Eat – Chicken Marsala

Chicken Marsala is one of those dishes I thought was hard to make, and was delighted to find out that it’s actually pretty simple. And… it tastes decent on chemo.

This recipe is from The Recipe Critic

Creamy Chicken Marsala

Ingredients

4 boneless skinless chicken breasts, thinly sliced
salt and pepper
2 tablespoons olive oil
1½ cups sliced mushrooms
½ cup Marsala wine (found near the condiments)
½ cup chicken broth
1 cup heavy whipping cream
1 teaspoon ground mustard
1 teaspoon garlic powder
Fresh Chopped Parsley for garnish

Instructions

In a large skillet over medium heat add 1 tablespoon olive oil to the pan. Add the chicken and lightly salt and pepper. Cook until lightly brown and cooked throughout. Remove chicken and set aside on plate.

Add 1 Tablespoon olive oil and sauté the mushrooms for 1-2 minutes. Add marsala wine and bring to a boil over medium high heat for 1-2 minutes. This allows the alcohol to burn out. Add the chicken broth, heavy whipping cream, ground mustard, and garlic powder. Bring to a boil and reduce heat and simmer for about 10 minutes or until it starts to thicken. Place chicken back in the sauce and continue to simmer for about 1-2 minutes.

Serve over egg noodles or with mashed potatoes and a vegetable.

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Radiation Complete – Check!

Ringing Out

August 23, 2018

Finally done. I finished the boost week of radiation today. As of today, I’ve had 7-1/2 weeks of radiation total. My skin is pink like I have a decent sunburn. There is still a spot on my collar bone on my right side that is more burned than the rest of my chest. The nurse and I were concerned that it was going to open up over the weekend. I’ve been keeping it well moisturized and covered with Mepilex. Monday morning, it was starting to heal, thankfully. I wasn’t looking forward to using Silvadene on it. Silvadene permanently stains anything it touches. I don’t have a lot of clothes that I don’t care at all about, and certainly none that I could wear to work.

I tried taking video of my final two radiation treatments. This is one of those lessons learned moments. I would love to have a Go Pro camera but I didn’t want to spend that much on having one. Mostly because I am not big on video and it seemed like a lot of money for something I wouldn’t use every day. So, during Amazon’s Prime Day, there was a cheap little dash cam that was about $50. I bought one. Unsurprisingly, it’s not everything I’ve dreamed of. Nor is the little waterproof video camera I bought last year. I couldn’t get the dash cam to format its memory card much less do anything else. I got the other camera configured, but its controls were really clunky. We taped the 4K camera to the radiation machine, but it wasn’t set to record, and we couldn’t tell that before starting the radiation program. I also tried to use my phone to take video from where my head rests so that you could see what I saw every day. All I got was a picture of the towel under my arm and some muffled audio. Dammit.

After I was finished and changed back into my clothes, the nurse went over my discharge paperwork. This is a form I’m going to need to hang onto in case I ever need surgery or other radiation treatment to any part of my chest ever again. It tells me how many grays (Gy) of radiation I’ve received for each part of the radiation plans and for how long. Grays are measurements of energy like volts or kilowatts. Any future radiation oncologist will need to know this because there is a maximum amount of radiation dose you can have in a lifetime. Surgeons will need to know because the tissue that was radiated will heal differently than tissue that wasn’t. What this generally means for me is that if I have a cancer recurrence in the same breast, or in the radiated half of the other side, I will likely have to have a full mastectomy and reconstruction both due to not being able to re-radiate that same tissue and that it won’t heal the same a second time.

When we were done with the discharge paperwork she wanted me to “ring out” of treatment. The hard part is that I’m not really done. For most other women who’ve had chemo, a lumpectomy or mastectomy, and radiation, they’re done when radiation is done. They’re declared “cancer-free.” I’m not there yet. I still have a chemo treatment left, and I won’t know if any of this worked and I’m cancer-free until November or December.

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What to Eat – Pork Carnitas

Carnitas, Houston style

I discovered pork carnitas during the 14 years I lived in Houston, TX. There hasn’t been a place I’ve been since that has carnitas that come anywhere close to my favorite places in Houston. Until I found this recipe. Thankfully, it’s really easy.

There are 2 Homesick Texan recipes for this deliciousness. The main difference between them is the addition of lime juice and garlic in the SmittenKitten version. This is the one I use most often. The other I’ll use if I have guests who aren’t as fond of garlic as I am.

Homesick Texan from SmittenKitten

Homesick Texan’s Site & Cookbook

Ingredients

3 pounds boneless pork shoulder or pork butt, cut into 2-inch cubes *
1/2 cup orange juice
1/4 cup lime juice (from about 2 to 3 limes)
4 cloves garlic, peeled and crushed
1 teaspoon ground cumin
1 teaspoon Kosher salt, plus more to taste

For Serving: Corn tortillas, Avocado slices, chopped cilantro and fixings of your choice (we love pickled jalapenos or onions, lime wedges and a bit of slaw)

Instructions

Place the pork in a large Dutch oven or heavy pot. Add the orange juice, lime juice, garlic, cumin, salt and enough water to just barely cover the meat. Bring the pot to a boil and then reduce the heat to a simmer. Simmer uncovered for two hours. Don’t touch the meat.

After two hours, increase the heat to medium-high and while occasionally stirring and turning the pieces, continue to cook for about 45 minutes, or until all of the liquid has evaporated, leaving only the rendered pork fat. Let it sizzle in this fat long enough to brown at the edges, turning pieces gently (they’ll be eager to fall apart), only as needed.

When pork has browned on both sides, it’s ready. Adjust seasonings to taste and serve on warmed tortillas with fixings.

Recipe Notes

The key to this recipe is that the meat has fat, so don’t trim it! If there’s not enough fat on the meat the recipe will turn out too dry. Whether to shred the meat like pulled pork or leave it in cubes I think is determined by what you’re used to eating. Texas isn’t a pulled-pork state so the texture isn’t as familiar as nicely done chunks. Likewise, I think the brilliance of this recipe lies in its simplicity. You can add as many different spices, herbs and aromatics as you like—but if you have good-tasting, happy pork why not let its flavor shine with just a bit of salt? Ultimately, however, making carnitas is a highly personal affair and so make them as they best suit you!

* You can use bone-in pork shoulder roast. It’s usually a little cheaper and major grocery stores usually have good sales on this way more often than they do the boneless version. When I get the bone-in version, it’s usually an 8 lb roast so I’ll have the butcher cut it in half and freeze one. I can still cut most of it into 2-inch cubes. I cut as close the bone as I can and put the bone in the bottom of the pot. When it’s cooked down, the meat comes off the bone really easily.

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Last “Regular” Radiation

August 16, 2018

Today was my last “regular” radiation treatment. Starting tomorrow, I will be starting a week of boost. This is a milestone of sorts. Not quite done yet, though.

I’m happy to be 5 days out from finally being done with daily radiation treatments, the burns and the chemo. More the chemo than the rest of it. The burns aren’t that bad, although I’m told they will get worse over the next couple of weeks. The reactions to the chemo have gotten progressively worse over the course of treatment. My body’s had enough and I’ve had enough of the side effects, too.

When radiation’s done I’ll be happy to get those couple of productive hours of my schedule back rather than wasting them on commuting either to and from radiation or to and from the office later in the morning. It really is hard when you have anywhere from 3-6 productive hours in a day and they’re wasted sitting in traffic behind people who have nowhere to be.

It will be interesting to see how the boost plan differs from the regular plans. It will treat much smaller and more targeted areas than the “regular” plans. I’ll get a higher dose of the radiation to those areas than I have been for the past 6 weeks.

 

 

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